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Characterization of patients with recurrent ischaemic stroke using the ASCO classification
M E Wolf1, T Sauer, M G Hennerici
1Department of Neurology, Universitaetsmedizin Mannheim, University of Heidelberg, Mannheim, Germany. wolf@neuro.ma.uni-heidelberg.de
European Journal of Neurology
|January 9, 2013
Summary
The etiology of recurrent ischemic stroke can change, with cardioembolism increasingly prevalent and often undertreated. The ASCO score effectively monitors evolving risk factors in stroke patients.
Area of Science:
- Neurology
- Cardiology
- Vascular Medicine
Background:
- The ASCO score aids in comprehensively characterizing ischemic stroke patients and their risk factors.
- It categorizes stroke etiologies into atherosclerotic changes (A), small vessel disease (S), cardiac sources (C), and other (O).
- The score may help identify patterns in recurrent ischemic stroke and evolving risk factor constellations.
Purpose of the Study:
- To analyze the distribution and changes in etiologies of recurrent ischemic stroke using the ASCO score.
- To document the evolution of risk factor constellations in patients experiencing recurrent ischemic strokes.
Main Methods:
- Prospective screening of a stroke database for recurrent ischemic stroke patients (2004-2011).
- Classification of each stroke event using the ASCO score.
- Analysis of etiology distribution and documentation of ASCO score modifications for each patient.
Main Results:
- 131 patients with recurrent ischemic stroke were identified.
- Significant modifications in ASCO score components were observed in 64.9% of patients.
- At recurrence, there was an increased prevalence of cardioembolic sources (grade 1) compared to the initial event.
Conclusions:
- The etiology of recurrent ischemic stroke is not always consistent with prior events.
- An increasing prevalence of cardioembolism, often inadequately treated, was a key finding at stroke recurrence.
- The ASCO score is a valuable tool for monitoring risk factor constellations in patients with recurrent ischemic stroke.
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